title: Simple clinical risk score identifies patients with serrated polyps in routine practice.
abstract: Large, proximal, or dysplastic (LPD) serrated polyps (SP) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having ≥1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic, and histologic features of serrated polyps in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having ≥1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2,244 patients in the derivation and 2,402 patients in the validation cohort; 6.3% and 8.2% had ≥1 LPD SP, respectively. Independent risk factors for LPD SPs were age of more than 50 years [OR 2.2; 95% confidence interval (CI), 1.3-3.8; P = 0.004], personal history of serrated polyps (OR 2.6; 95% CI, 1.3-4.9; P = 0.005), current smoking (OR 2.2; 95% CI, 1.4-3.6; P = 0.001), and nondaily/no aspirin use (OR 1.8; 95% CI, 1.1-3.0; P = 0.016). In the validation cohort, a SP score ≥5 points was associated with a 3.0-fold increased odds for LPD SPs, compared with patients with a score <5 points. In the present study, age of more than 50 years, a personal history of serrated polyps, current smoking, and nondaily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Mariëlle W E
authors.initials: MW
authors.lastname: Bouwens
authors.forename: Bjorn
authors.initials: B
authors.lastname: Winkens
authors.forename: Eveline J A
authors.initials: EJ
authors.lastname: Rondagh
authors.forename: Ann L
authors.initials: AL
authors.lastname: Driessen
authors.forename: Robert G
authors.initials: RG
authors.lastname: Riedl
authors.forename: Ad A M
authors.initials: AA
authors.lastname: Masclee
authors.forename: Silvia
authors.initials: S
authors.lastname: Sanduleanu
mesh_terms: D003111:Colonic Polyps / Q000150:complications / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012307:Risk Factors; D054928:Validation Studies as Topic